EB5AN Sample Source of Funds Cover Letter 1-1

Part [XX]: Petitioner’s Background and Lawful Source of Funds
Overview of Petitioner’s Source of Funds
Petitioner owns [XX]% of [Name of Asset Used as Collateral], [brief description of

asset, including address of immovable asset] (the “Shortened Name of Asset”), which is
valued at $[XX]. See Exhibit 1, [Asset Valuation Letter]; see Exhibit 2, [Third-Party Proof
of Asset’s Existence/Operation]. Thus, Petitioner’s share of the [Shortened Name of Asset]
has an implied valuation of $[XX% of value]. The [Shortened Name of Asset] and the [XX
parcels of land on which the building is constructed] represent(s) the “Collateral.” See
Exhibit 3, Deed of Mortgage.
The Collateral was previously held by [Name of Original Title Holder]. [Name of
Original Title Holder] died on [date of death], and upon his death and as per the terms set out
in his will, 100% of the ownership of the [Shortened Name of Asset] was transmitted by
operation of law to the surviving spouse, [Name of Surviving Spouse] ([XX]% ownership),
and each of the couple’s [XX] children, [Name of Petitioner] ([XX]% ownership), [Name of
Beneficiary 2] ([XX]% ownership), and [Name of Beneficiary 3] ([XX]% ownership),
making each of the [XX] surviving family members co-owners of the [Shortened Name of
Asset]. See Exhibit 4, Death Certificate of [Name of Original Title Holder]; see Exhibit 5,
Will of [Name of Original Title Holder]; see Exhibit 6, Certificates of Title for [Shortened
Name of Asset].
On [date], [Name of Donor] and [Name of Petitioner] executed a deed of donation

(the “Deed of Donation”) in which [Name of Donor] gifted [XX]% of [his/her] ownership
share to [Name of Petitioner]. See Exhibit 7, Deed of Donation.
On [date], Petitioner received a loan for $[XX] (the “[Name of Asset] Loan”) from
[Name of Lender], a natural person (“[Lender’s Surname]”). See Exhibit 8, Passport for
[Name of Lender]; see Exhibit 9, 2018 [State] Tax Return for [Name of Lender]. The [Name
of Asset] Loan is directly and solely secured by a deed of mortgage on the Collateral and a
personal guaranty granted by Petitioner in favor and for the benefit of [Lender’s Surname].
Taxes related to the recording of the mortgage in the public record were paid on [date]. See
Exhibit 10, Petitioner Loan Agreement; see Exhibit 11, Petitioner Note; see Exhibit 12,
Petitioner Personal Guaranty; see Exhibit 3, Deed of Mortgage; see Exhibit 13, [Shortened
Name of Asset] Valuation Letter; see Exhibit 14, Monthly Documentary Stamp Tax
Declaration Return for the Recording of the Deed of Mortgage.
Source of [Asset Name] Loan
The [Asset Name] Loan, advanced by [Lender’s Surname] on [date], is ultimately

derived from funds disbursed as dividends from [Name of Company], a [State] [company
type] (“[Company Short Name]”) formed on [date], of which [Lender’s Surname] is a
managing member. See Exhibit 15, Certificate of Formation of [Name of Company]; see
Exhibit 16, FEIN Letter from IRS for [Name of Company]; see Exhibit 17, Operating
Agreement for [Name of Company].
[Company Short Name] was formed with zero initial startup funding. See Exhibit 18,
[Name of Bank] Statements for [Name of Company], Account #[XX] from [date] through
[date]. The company provides the following services (see Exhibit 17, Operating Agreement
for [Name of Company]):
(i) [Service description 1];
(ii) [Service description 2];
(iii) [Service description 3]; and
(iv) [Service description 4]
Since its formation, [Company Short Name] has derived income from services
rendered to clients. All funds were earned by lawful means in exchange for services rendered,
and the taxes on all earnings have been paid. [XX] client invoices totaling $[XX] for services
rendered with payment received during the period of [date] through [date] have been included
as Exhibit 19, [Name of Company], Select Invoices for Year Ending [date]. See Exhibit 20,
[Name of Company], Audited Financial Statements for Year Ending [date]; see Exhibit 21,
[Name of Company], Tax Return for Year Ending [date]; see Exhibit 22, [Name of Bank]
Statements for [Name of Company], Account #[XX] from [date] through [date].
The table below provides a quick reference correlating the itemized invoices in
Exhibit 19, presented in the same order as on the pages on which the relevant transactions
appear in the bank statements for [Company Short Name] in Exhibit 22, as indicated in the
right-most column of the table. These select transactions are highlighted in Exhibit 22.
Statement
Item # Invoice Paid Invoice Amount Page
(Exhibit 19) Date Date # Client Name ($) (Exhibit 22)
XX dividends were disbursed, the first on [date] in the amount of $[XX], the second
on [date] in the amount of $[XX], and the [XX] on [date] in the amount of $XX (together, the
“Dividends”), for an aggregate amount of $[XX] in disbursed dividends. [Lender’s Surname]
received total dividends of $[XX] for the year ending [date], from [Name of Company],
which includes the Dividends. See Exhibit 9, 2018 [State] Tax Return for [Name of Lender];
see Exhibit 23, Tax-related Documents for [Name of Company] Showing Dividend
Disbursement; see Exhibit 20, [Name of Company], Audited Financial Statements for Year
Ending [date]; see Exhibit 21, [Name of Company], Tax Return for Year Ending [date]; see
Exhibit 22, [Name of Bank] Statements for [Name of Company], Account #[XX] from [date]
through [date]; see Exhibit 24, [Name of Bank] Statements for [Name of Lender] Personal
Account, Account #[XX] from [date], through [date].
The Dividends represent the first disbursements from [Company Short Name] to
[Lender’s Surname], and according to [State] auditing rules, they are shown in the audited
financial statements of [Company Short Name]. See Exhibit 20, [Name of Company],
Audited Financial Statements for Year Ending [date]; see Exhibit 21, [Name of Company],
Tax Return for Year Ending [date]; see Exhibit 25, Advanced Members Capital Dividend
Explanation Letter.
Summary of Exhibits
Exhibit 1, [Asset Valuation Letter]
Exhibit 2, [Third-Party Proof of Asset’s Existence/Operation]
Exhibit 3, Deed of Mortgage
Exhibit 4, Death Certificate of [Name of Original Title Holder]
Exhibit 5, Will of [Name of Original Title Holder]
Exhibit 6, Certificates of Title for [Shortened Name of Asset]
Exhibit 7, Deed of Donation
Exhibit 8, Passport for [Name of Lender]
Exhibit 9, 2018 [State] Tax Return for [Name of Lender]
Exhibit 10, Petitioner Loan Agreement
Exhibit 11, Petitioner Note
Exhibit 12, Petitioner Personal Guaranty
Exhibit 13, [Shortened Name of Asset] Valuation Letter
Exhibit 14, Monthly Documentary Stamp Tax Declaration Return for the Recording of the
Deed of Mortgage
Exhibit 15, Certificate of Formation of [Name of Company]
Exhibit 16, FEIN Letter from IRS for [Name of Company]
Exhibit 17, Operating Agreement for [Name of Company]
through [date]
Exhibit 19, [Name of Company], Select Invoices for Year Ending [date]
Exhibit 20, [Name of Company], Audited Financial Statements for Year Ending [date]
Exhibit 21, [Name of Company], Tax Return for Year Ending [date]
through [date]
Exhibit 23, Tax-related Documents for [Name of Company] Showing Dividend
Disbursement
Exhibit 24, [Name of Bank] Statements for [Name of Lender] Personal Account, Account
#[XX] from [date] through [date]
Exhibit 25, Advanced Members Capital Dividend Explanation Letter

EB5AN Sample Source of Funds Cover Letter 1-1

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Part [XX]: Petitioner’s Background and Lawful Source of Funds

Overview of Petitioner’s Source of Funds

Petitioner owns [XX]% of [Name of Asset Used as Collateral], [brief description of

On [date], [Name of Donor] and [Name of Petitioner] executed a deed of donation

Source of [Asset Name] Loan

The [Asset Name] Loan, advanced by [Lender’s Surname] on [date], is ultimately

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